Provider Demographics
NPI:1144936527
Name:MINASE, TRUFAT
Entity type:Individual
Prefix:
First Name:TRUFAT
Middle Name:
Last Name:MINASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 ROSEMARY HILLS DR UNIT R1
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2454
Mailing Address - Country:US
Mailing Address - Phone:240-478-4859
Mailing Address - Fax:
Practice Address - Street 1:1915 ROSEMARY HILLS DR UNIT R1
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2454
Practice Address - Country:US
Practice Address - Phone:240-860-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD93233991Medicaid